Survival and quality of life outcomes of high-intensity focused ultrasound treatment of localized prostate cancer
Background: To evaluate the survival and quality of life (QoL) outcomes of high-intensity focused ultrasound (HIFU) whole-gland ablation for localized prostate cancer. Methods: Over 8 years, men with localized prostate cancer treated with whole-gland HIFU were prospectively followed. Transrectal pro...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2020-06-01
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| Series: | Prostate International |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2287888220300040 |
| _version_ | 1827836106426548224 |
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| author | Peter L. Royce James J.Y. Ooi Selva Sothilingam Henry H. Yao |
| author_facet | Peter L. Royce James J.Y. Ooi Selva Sothilingam Henry H. Yao |
| author_sort | Peter L. Royce |
| collection | DOAJ |
| description | Background: To evaluate the survival and quality of life (QoL) outcomes of high-intensity focused ultrasound (HIFU) whole-gland ablation for localized prostate cancer. Methods: Over 8 years, men with localized prostate cancer treated with whole-gland HIFU were prospectively followed. Transrectal prostate ablation was performed under general anesthesia with Sonablate-500® (Sonacare Medical©, Charlotte, North Carolina, USA). The primary outcome was failure-free survival defined as no transition to any of the following: (1) local salvage therapy (surgery or radiotherapy), (2) systemic therapy, (3) metastases, or (4) prostate cancer–specific mortality. Secondary outcomes included both survival outcomes and QoL measures. Results: Of 70 men, 29.7% had International Society of Urological Pathology (ISUP) grade 1, 43.8% ISUP 2, 10.9% ISUP 3, and 15.6% ISUP 4 disease. At median follow-up of 83.4 months, overall mortality was 8.6% and prostate cancer–specific mortality 0%. Failure-free survival was 78.2% at 5 years and 71.2% at 7 years. Of all men, 7.1% of men developed metastases, with median metastasis-free survival of 75.4 months. There was negligible post-HIFU urinary incontinence or lower urinary tract symptom with a median Male Urogenital Distress Inventory score of 32 at 6 months and 33 at 12 months and median IPSS of 4 at 6 months and 3 at 12 months. Median Radiation Therapy Oncology Group rectal toxicity score was 0 throughout. In men who had mild or no erectile dysfunction at baseline (International Index of Erectile Function ≥17), the mean International Index of Erectile Function score declined to 37% from 23.5 at baseline to 14.7 at 12 months. Conclusion: At median follow-up of 7 years, whole-gland HIFU appears to have comparable survival outcomes with other cohort studies involving radical prostatectomy and radiotherapy patient. It has low impact on QoL, preserved urinary continence, and erectile function approximate to nerve-sparing prostatectomy. Whole-gland HIFU presents a potential alternative minimally invasive and safe option for the treatment of localized prostate cancer. |
| first_indexed | 2024-03-12T06:21:01Z |
| format | Article |
| id | doaj.art-9e8b33bcc62e4b839c494b767225d094 |
| institution | Directory Open Access Journal |
| issn | 2287-8882 |
| language | English |
| last_indexed | 2024-03-12T06:21:01Z |
| publishDate | 2020-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Prostate International |
| spelling | doaj.art-9e8b33bcc62e4b839c494b767225d0942023-09-03T02:15:08ZengElsevierProstate International2287-88822020-06-01828590Survival and quality of life outcomes of high-intensity focused ultrasound treatment of localized prostate cancerPeter L. Royce0James J.Y. Ooi1Selva Sothilingam2Henry H. Yao3Department of Urology, Alfred Health, Melbourne, Victoria, Australia; Urology Associates, Cabrini Health, Malvern, Victoria, Australia; Corresponding author. Suite 51, Cabrini Hospital, 183 Wattletree Road, Malvern, 3144, Australia.Department of Urology, Alfred Health, Melbourne, Victoria, AustraliaUniversity of Malaya, Kuala Lumpur, MalaysiaDepartment of Urology, Alfred Health, Melbourne, Victoria, AustraliaBackground: To evaluate the survival and quality of life (QoL) outcomes of high-intensity focused ultrasound (HIFU) whole-gland ablation for localized prostate cancer. Methods: Over 8 years, men with localized prostate cancer treated with whole-gland HIFU were prospectively followed. Transrectal prostate ablation was performed under general anesthesia with Sonablate-500® (Sonacare Medical©, Charlotte, North Carolina, USA). The primary outcome was failure-free survival defined as no transition to any of the following: (1) local salvage therapy (surgery or radiotherapy), (2) systemic therapy, (3) metastases, or (4) prostate cancer–specific mortality. Secondary outcomes included both survival outcomes and QoL measures. Results: Of 70 men, 29.7% had International Society of Urological Pathology (ISUP) grade 1, 43.8% ISUP 2, 10.9% ISUP 3, and 15.6% ISUP 4 disease. At median follow-up of 83.4 months, overall mortality was 8.6% and prostate cancer–specific mortality 0%. Failure-free survival was 78.2% at 5 years and 71.2% at 7 years. Of all men, 7.1% of men developed metastases, with median metastasis-free survival of 75.4 months. There was negligible post-HIFU urinary incontinence or lower urinary tract symptom with a median Male Urogenital Distress Inventory score of 32 at 6 months and 33 at 12 months and median IPSS of 4 at 6 months and 3 at 12 months. Median Radiation Therapy Oncology Group rectal toxicity score was 0 throughout. In men who had mild or no erectile dysfunction at baseline (International Index of Erectile Function ≥17), the mean International Index of Erectile Function score declined to 37% from 23.5 at baseline to 14.7 at 12 months. Conclusion: At median follow-up of 7 years, whole-gland HIFU appears to have comparable survival outcomes with other cohort studies involving radical prostatectomy and radiotherapy patient. It has low impact on QoL, preserved urinary continence, and erectile function approximate to nerve-sparing prostatectomy. Whole-gland HIFU presents a potential alternative minimally invasive and safe option for the treatment of localized prostate cancer.http://www.sciencedirect.com/science/article/pii/S2287888220300040Erectile dysfunctionHigh-intensity focused ultrasound ablationProstatic neoplasmsQuality of lifeTreatment outcomeUrinary incontinence |
| spellingShingle | Peter L. Royce James J.Y. Ooi Selva Sothilingam Henry H. Yao Survival and quality of life outcomes of high-intensity focused ultrasound treatment of localized prostate cancer Prostate International Erectile dysfunction High-intensity focused ultrasound ablation Prostatic neoplasms Quality of life Treatment outcome Urinary incontinence |
| title | Survival and quality of life outcomes of high-intensity focused ultrasound treatment of localized prostate cancer |
| title_full | Survival and quality of life outcomes of high-intensity focused ultrasound treatment of localized prostate cancer |
| title_fullStr | Survival and quality of life outcomes of high-intensity focused ultrasound treatment of localized prostate cancer |
| title_full_unstemmed | Survival and quality of life outcomes of high-intensity focused ultrasound treatment of localized prostate cancer |
| title_short | Survival and quality of life outcomes of high-intensity focused ultrasound treatment of localized prostate cancer |
| title_sort | survival and quality of life outcomes of high intensity focused ultrasound treatment of localized prostate cancer |
| topic | Erectile dysfunction High-intensity focused ultrasound ablation Prostatic neoplasms Quality of life Treatment outcome Urinary incontinence |
| url | http://www.sciencedirect.com/science/article/pii/S2287888220300040 |
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